We are often under the impression that the healthcare industry is in place to service patients. In the same way science carries a presumptive credibility over its modus operandi, health culture has emerged as a preoccupation in and of itself. Of one such development is the medicalization of society.
The Social Construction of Medical Knowledge
Due to the social construction of medical knowledge, rarely is the reality shed that diseases are more commonly made, rather than discovered. According to Benjelloun (2019), “being the self-enterprising carpetbaggers that humans are, medical advancement in science is one of few public sectors that goes unprecedentedly unquestioned.”
Moving forward with this sentiment, the medical industry knowingly lures the public into both figuratively and literally buying anything they offer and getting away with it because it is assumed to be for the betterment of their lives. With such a charade going on, they are able to broaden definitions of natural human conditions and sell them as illnesses. On how these processes come to be and are practiced, will be expounded upon below using social anxiety disorder as a primary example.
To clarify social construction first and foremost, it is a theory that attempts to make sense of the world by understanding how social categories such as class, birth, gender, race, death, economic and political status, etc. attribute to the construction and evolution of society, rather than it being a naturally given state from the get-go.
Medical knowledge, much like social institutions, is then, also a product of constructionism. The authority that is granted to medical knowledge is what enables medicalization.
Medicalization is a process that labels non-medical problems and treats them as though they are. If the public is convinced that organizations like hospitals, pharmaceuticals, and insurance companies engage enough with the selected disease, then doctors and other professionals are vested to broaden the definition of the given disease, and prescribe treatment or medication for it as they please.
For instance, according to Weitz (2017), “doctors expanded the definition of osteoporosis to include anyone with low bone density, rather than the only individuals who had experienced unusual bone fractures.” Similarly, improved standard living conditions during the 20th century saw a considerable decline in sick children. The decreased urgency of pediatrics ensued.
Weitz (2017) further states, “pediatrics thus became less well paid, interesting, and prestigious. To increase their market while obtaining satisfying and prestigious work, some pediatricians have expanded their practices to include children whose behavior concerns their parents.” Therefore, through the tool of medicalization, new definitions of health scenarios are created in order to elevate a doctor’s role, power, and income.
Diagnosing Social Anxiety Disorder
In this manner of mongering diagnoses, everyday and ordinary emotions and behavior such as stress or shyness are clustered into one disease — social anxiety disorder. Grob and Horwitz (2009) argue, “doctors have played similar roles in medicalizing crooked noses, obesity, drinking during pregnancy, impotence, and numerous other conditions.”
In the Western world, loudness and extroversion is celebrated. As a result, the human experience is reduced into a binary way of living in which the former is pegged as a normality. In contrast, individuals who possess shyness or similar traits are, therefore, subject to stigmatization. In consequence, it is the act of medicalization itself of social anxiety disorder (or SAD, for short), that is the source of that fear.
Social Anxiety Disorder (SAD) vs. Shyness
To elaborate, the interpretations of social anxiety disorder and shyness will be compared. According to a study done by Dr. Dalrymple on Treating Social Anxiety Disorder in a peer reviewed journal titled Current Psychiatry, SAD is a fear of embarrassment or humiliation in social or performance-based situations.
In contrast, shy people are defined as self-reporting to have greater anxiety and embarrassment in social situations than non-shy persons do; it also refers to exhibiting habits of anxiety, inhibition, reticence, or a combination of these findings, in social and interpersonal situations. Of course, this is only logical.
Furthermore, according to Allyn & Bacon (2001), shyness has been described as “a normal facet of personality and a stable temperament.” Supplemented with an NCS Adolescent study, it has been found nearly 50% of adolescents self-identified as shy.
It is almost ironic how the line between the characteristic of shyness and SAD is so thin. Given that someone can so easily be mistaken for having a disorder, it is no wonder an individual will fear judgement from others by even remotely acting shy. Internalizing that fear, the individual will have no choice but to accept what is otherwise just an over-diagnosis, and the construction or (more appropriately) invention of fear.
The Sanctioning System of New Illnesses
On that note, medicalization has borne harmful (despite initially unintended) consequences. “In addition to creating new illnesses,” says Boyer and Lutfey (2010), “medicalization has also led to labeling increasing numbers of individuals as ‘potentially ill.’” As one can guess from context, this means individuals who are high risk for becoming a patient of said new illness often then become patients of said new illness.
With the aid of media and culture to impose biomedical values and use them as a measurement of health norms, people end up pathologizing supposed “symptoms” of anxiety. Indoctrinated into thinking biomedicine is their savior and resolver of all their problems, individuals will seek out a certain body image, health practice, diet, lifestyle, and attitude, unconsciously beginning a domino effect on damaged self-esteems.
That race to fit in ends up being the generator and root of genuine anxiety. It is more profitable to promote medicine as a corrector of deviance because people are more inclined to follow a sanctioning system that appears to be apolitical and cultural-free on the surface. But in fact, as with legal and religious institutions, medicine too has found its way into court orders and deciding moral issues.
It is more profitable to promote medicine as a corrector of deviance because people are more inclined to follow a sanctioning system that appears to be apolitical and cultural-free on the surface. But in fact, as with legal and religious institutions, medicine too has found its way into court orders and deciding moral issues.
Defined by Genes
In view of this, Weitz (2017) argues, “doctors become the only experts considered appropriate for diagnosing the problem and for defining appropriate responses to it.” A woman intuitively “knowing” she is pregnant for example, is ignored because it can only be “truly” verified from a medical analysis or a doctor’s diagnosis.
In some countries (e.g. China), if it were found that a citizen dissents from the political superstructure, they will be admitted into a mental hospital, keeping them out of public eye, and silencing their existence. “In other words, medicalization allowed these governments to depoliticize the situation,” states Weitz (2017).
Additionally, in the United States, in order for a person to become a citizen through family ties (i.e. the spouse, parent, or child of a US citizen), the federal government requires that they prove it through genetic testing, according to Lakhani and Timmermans (2014).
At first glance, this sounds legitimate, until it is realized that this would exclude stepchildren, adopted children, children from polygamous families, and families from backgrounds where it is culturally accepted to adopt nieces, nephews, and cousins from whom parents are unfit or have died.
Furthermore, US citizenship via genetic testing denies legal documents, a parent’s sworn statement, or a child’s obvious desire to be with the adults they love. “Mandated genetic testing can rip apart — rather than unite — families when it reveals that a child is not genetically related to a man long assumed to be his or her father,” says Weitz (2017). Additionally, “it implicitly declares that we are all defined by our genes.”
The (Monetized) Medicalization of Society
Using these tactics, “experts” can monetize conditions to make people spend more than needed. In the case of social anxiety disorder, antidepressants and other drugs may be offered when psychotherapy alone may be sufficient. To relate, the US healthcare system wastes 765 billion dollars a year on unnecessarily prescribed medicine. That is more money spent than by the Department of Defense.
One sample of this is eye drops. Eye drops always roll down people’s faces because one drop is actually larger than what the human eye can physically hold. Drug companies purposefully make eye drops oversized so that the solution is wasted and runs out faster, causing one bottle to barely last a month and patients to spend twice as much. It is the same with cancer drugs.
Imagine, then, how this ploy is carried out for SAD, given its prevalence as evidenced above and assuming the diagnosis is not a false positive to begin with.
All around, the healthcare system is more of an industry than it is a resourceful amenity. Owing to the medicalization of society, side effects include vulnerability and guilt towards one’s feelings, body, and behavior, being assigned near nonexistent sick roles, and conned into being one sickness away from bankruptcy. As Goethe said (quoted in Rieff (1966)), “I, too, believe that humanity will win in the long run; I am only afraid that at the same time the world will have turned into one huge hospital where everyone is everybody else’s humane nurse.”
Benjelloun, N. (2019, August 13). Is Medicine Neutral and Universal? Literary Yard. Literary Yard. literaryyard.com/2019/08/13/is-medicine-neutral-and-universal/.
Chakraborty, R. (2017, October 18). How Drug Companies Make You Buy More Medicine than You Need. Vox. www.vox.com/videos/2017/10/18/16496590/how-drug-companies-waste-medicine.
Dalyrymple, K. (2013). When Does Benign Shyness Become Social Anxiety, a Treatable Disorder? Current Psychiatry. mdedge-files-live.s3.us-east-2.amazonaws.com/files/s3fs-public/Document/September-2017/021_1113CP_Dalrymple_FINAL.pdf.
Parens, E. (2011). On Good and Bad Forms of Medicalization. Bioethics. www.thehastingscenter.org/uploadedFiles/About/People/Staff/Good%20and%20bad%20forms%20of%20medicalization%20early.pdf.
Weitz, R. (2017). The Sociology of Health, Illness, and Health Care: A Critical Approach. Cengage Learning, Inc.
Nadia Benjelloun is a native from Tangier, Morocco, and ia a poet, novelist, and essayist. As well as freelance writer, she is also an associate editor for Typehouse Literary Magazine. She has been featured or forthcoming in The Literary Yard, Eskimo Pie, In Parenthesis Journal, The Scarlet Leaf Review, DM du Jour at Danse Macabre, The Book Smuggler’s Den, and the Sagebrush Review. Additionally, her work has been present in numerous anthologies since 2009.